Family Planning and Diarrhea Knowledge, Attitude and Practices (KAP) in GGMS Project Districts, Nepal Follow-up Study, 2013

Abstract

Background: USAID/Nepal’s Ghar Ghar Maa Swasthya (GGMS), or “Healthy Homes”, project seeks to assist the Government of Nepal (GON) to expand the depth, reach, and impact of the private sector in social marketing for family planning (FP), maternal and child health (MCH), and HIV/AIDS prevention. Methods: Information required for the purpose of the study was collected using quantitative techniques, an interviewer-administered questionnaire. The study population represented 49 ‘hard-to-reach’ districts covered by GGMS Project. The study was conducted using a structured questionnaire leading to quantitative information generation and administration to 1620 married women of reproductive age (MWRA) between ‘15 to 49 years’ from the study areas of the hill and mountain districts. The design for the survey was a stratified probability sampling design for which a three stage stratified cluster sampling was employed. The survey was conducted between June 12 and July 20, 2013. The data entry program was created using the FoxPro software. Data were entered/processed using FoxPro database and SPSS software packages. SPSS system file was prepared for output generation and analysis. Results: Only 44% of married women currently use a method and 31% have never used any method. Seventeen percent used injectables, while unmet need was 46%. Awareness on number of contraceptive methods was very high. Husbands seem to have a major influence on deciding current method. Highest number never used contraception as their husbands were away followed by they want to have (more) children. Reported levels of provider explanation about possible side effects and what to do about them were low. Brand awareness was low for injectables and condoms, with Depo-Provera, Sangini, and Dhaal each reaching about 50% spontaneous brand awareness. Radio was the most mentioned source for information received in the last six months for both injectables and condoms, followed by FCHV and health worker. Radio was also the most mentioned source for Emergency Contraception (EC) in the last six months, followed by TV and health worker. Persistent negative perceptions remain for specific methods: Injectables, condoms, and emergency contraception. The main barrier is that awareness and ever use of the product are both very low. Oral Rehydration Solution (ORS) awareness was quite high at 97% of women with at least one child under five, however only about 50% had ever used the product. Ever use of ORS was also lowest among the poorest Socio-economic Status (SES) quintile. Brand awareness (unaided) for Nava Jeevan was very low. Nava Jeevan’s comparative advantage was that it was recommended by FCHVs. Jeevan Jal’s comparative advantage was wide availability (including only brand available). Conclusions: It is important to design and use appropriate content and communication methods which are suited to specific audience segments. Keywords: attitude; diarrhea; family planning; Ghar Ghar Maa Swasthya Project; knowledge; practice.